Provider Demographics
NPI:1649644352
Name:B R YATES, DMD
Entity type:Organization
Organization Name:B R YATES, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-699-9509
Mailing Address - Street 1:252 HANNAH TODD PL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-9026
Mailing Address - Country:US
Mailing Address - Phone:859-699-9509
Mailing Address - Fax:
Practice Address - Street 1:810 CHEVY CHASE PL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-2144
Practice Address - Country:US
Practice Address - Phone:859-699-9509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty